Provider Demographics
NPI:1942290887
Name:MCCAULEY-TOTH, ANDREA (ATC)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:MCCAULEY-TOTH
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 SOMERSET DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-4519
Mailing Address - Country:US
Mailing Address - Phone:541-791-4923
Mailing Address - Fax:
Practice Address - Street 1:3950 SOMERSET DR NE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-4519
Practice Address - Country:US
Practice Address - Phone:541-791-4923
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAT-AT-10066362255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer